The B.C. Centre for Disease Control is launching an online partner notification service for people diagnosed with a sexually transmitted infection.
It's a note delivering an intimate message to a romantic partner – but this letter is definitely not sealed with a kiss.
"I'm so sorry," reads one, while a second states: "Sometimes there are strings attached."
Others are more direct and unsubtle, including one depicting a screw.
Such missives are now available on electronic postcards as British Columbia's provincial health authority aims to help people tell sex partners they may have been exposed to a sexually transmitted infection.
It's unwanted news, but could help people get treatment sooner and prevent the further spread of disease, said Mark Gilbert of the BC Centre for Disease Control.
"We're thinking about how can we use the Internet and ... doing it in a way that gives more control to people so that they can take more control over their own health," Mr. Gilbert said in an interview after the site was launched on Monday.
The free online service – available at www.bccdc.ca/inspot and www.inspot.org – allows individuals to send e-cards to up to six people at a time, in English, French or Spanish. Personal messages can be included, or the e-cards can be sent anonymously.
Recipients will be presented with information related to specific infections, treatment and a list of local testing clinics.
The agency will work with collaborating partners in Toronto and Ottawa, cities that have used the site already for several years, to create a survey that attempts to glean whether people who receive the e-cards actually get tested.
Dr. Gilbert said the new service wasn't launched in response to any kind of rise in infection rates, but is meant as another way to combat the thousands of cases of sexually transmitted infections diagnosed in B.C. each year.
Other jurisdictions, including Toronto and Ottawa, have experienced little misuse of the e-cards, but users can file a complaint if someone is found to have been sent a card as a joke.
"Some people have questioned the humour tone to some of the cards," Dr. Gilbert said, noting they were written after consultation with community groups and feedback from people who have been treated for such infections. "You can pick the card that suits you best."
Gilbert noted the system shouldn't replace existing methods of notifying partners, such as in-person contact or with the help of a public health nurse.
The concept was developed in San Francisco in 2004 by a company called ISIS, or Internet Sexuality Information Services, to address a rise in syphilis rates among gay men.
The company has since marketed the services more broadly across the United States and Canada.
"Most people who receive an e-card that says you may have been exposed to an STI will actually reach out, if they're sexually active they will reach out for services," said Deb Levine, ISIS executive director.
There's been no formal evaluation of how well it works, though Ms. Levine said she'd welcome the research. A total of 8,741 e-cards were sent in 2010, and the inspot.org website tallied more than 23,000 unique visitors from January to March, 2011.
No information on the sender or the receiver of the card is collected.
Wayne Robert, executive director the Vancouver-based Health Initiative for Men, said his group was consulted on the project and its philosophy is, the more options, the better.
"This isn't going to be something that works for everyone in every case, but it's another arrow in the quiver, another tool in the tool box," he said, noting people are also meeting for relationships and hookups online now more than ever before.
Regardless of whether the relationship is close or casual, what's most important is that the person at risk gets notified, he said.
"Generally, people want to do the right thing," he said. "Any way that can be made easier is great, and you not only get the message but you get the resources to deal with the issue."